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    Odds Ratios and Risk Ratios: What's The Difference and Why Does It Matter?

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    Odds Ratios and Risk Ratios: What's The Difference and Why Does It Matter?

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    jorgegrodl
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    Interesting beginning of an article

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    Or & RR

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    Interesting beginning of an article

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    59 views1 page

    Odds Ratios and Risk Ratios: What's The Difference and Why Does It Matter?

    Uploaded by

    jorgegrodl
    Interesting beginning of an article

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    CME Topic

    Odds Ratios and Risk Ratios: What’s the


    Difference and Why Does It Matter?
    Anthony J. Viera, MD, MPH

    it is important to understand the difference between odds


    Abstract: Odds ratios (OR) are commonly reported in the medical
    literature as the measure of association between exposure and out-
    ratios and risk ratios because their meanings and interpreta-
    come. However, it is relative risk that people more intuitively un-
    tions are quite different.2,3
    derstand as a measure of association. Relative risk can be directly
    determined in a cohort study by calculating a risk ratio (RR). In The Risk Ratio
    case-control studies, and in cohort studies in which the outcome In a cohort study, investigators begin by identifying the
    occurs in less than 10% of the unexposed population, the OR pro- presence or absence of an exposure (eg, cigarette smoking) in
    vides a reasonable approximation of the RR. However, when an two groups. They then follow the two groups over time (ie,
    outcome is common (iÝ10% in the unexposed group), the OR will prospectively) to determine the number in each group who
    exaggerate the RR. One method readers can use to estimate the RR develop the outcome of interest (eg, lung cancer). The num-
    from an OR involves using a simple formula. Readers should also ber of people who develop the outcome divided by the total
    look to see that a confidence interval is provided with any report of number in the group is called the incidence (Table 1). The
    an OR or RR. A greater understanding of ORs and RRs allows incidence is what we call the risk of developing the outcome
    readers to draw more accurate interpretations of research findings. in that group. The incidence (risk) in the exposed is then
    divided by the incidence (risk) in the unexposed to determine
    Key Words: odds ratios; risk ratios; relative risk; epidemiology; the ratio of the two risks: the risk ratio (RR), or relative risk.
    measures of association This RR tells us how many times more likely the outcome
    occurs among people with the risk factor (or exposure). If the
    RR ⫽ 1, then the risk is the same in the two groups. If the RR
    A s clinicians, we often want to know by how much a
    patient’s risk of having a health outcome is increased or
    decreased by the presence of some risk factor or exposure.
    is ⬎1, the risk of the outcome is greater in those with the
    exposure; and if the RR ⬍1, the risk of the outcome is lower
    in those with the exposure. For example, a cohort study pre-
    Investigators assist us in this manner by studying a group of
    senting a RR of 15 for the association between cigarette smok-
    people who have some risk factor (exposed group) and com-
    ing and lung cancer tells us that the incidence of lung cancer
    paring them with a group of people who do not have the risk
    in the smokers was 15 times that of the incidence of lung
    factor (unexposed group). After following both groups for
    cancer in the nonsmokers.
    some time, usually years, the investigators can determine how
    many times more likely it was that the exposed group devel-
    oped the outcome than the unexposed group. This number is The Odds Ratio
    called the risk ratio, or “relative risk.” In certain study designs In the calculation of risk (incidence) in each of the two
    or analytic techniques, however, the relative risk cannot be groups described above, the denominator in the ratio includes
    determined directly, and investigators report relative odds. This that which is mathematically represented in the numerator. This
    number is commonly called the odds ratio, and even authors of
    research articles may interpret this ratio incorrectly.1 As readers,

    Key Points
    From the Department of Family Medicine, University of North Carolina at • When an outcome in a research study is common (eg,
    Chapel Hill, Chapel Hill, NC.
    occurs in more than 10% of the unexposed group), the
    Reprint requests to Anthony J. Viera, MD, MPH, Department of Family Med-
    icine, University of North Carolina at Chapel Hill, 590 Manning Drive, CB odds ratio will tend to overestimate the risk ratio.
    7595, Chapel Hill, NC 27599. Email: anthony_viera@med.unc.edu • One method to estimate the odds ratio involves using
    Dr. Anthony Viera has no financial disclosures to declare. a simple formula.
    Accepted January 30, 2008. • A confidence interval should be provided along with
    Copyright © 2008 by The Southern Medical Association any report of an odds ratio or risk ratio.
    0038-4348/0⫺2000/10100-0730

    730 © 2008 Southern Medical Association

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